"Modicare": Can India Achieve Universal Healthcare?

At this year’s Independence Day speech in New Delhi’s historic Red Fort, Prime Minister Narendra Modi emphasized the need for universal health coverage for India’s impoverished, stating “It is essential to ensure that we free the poor of India from the clutches of poverty due to which they cannot afford healthcare.”

Just a month later, on September 22nd, India announced the rollout of the National Health Protection Mission (NHPM). Also known as “Modicare”, NHPM will provide impoverished families with health insurance coverage of up to 500,000 rupees (the equivalent of around 7,000 American dollars) every year. If effective as intended, it will cover close to 500 million Indians, or nearly half of India’s population, as the world’s biggest government-funded healthcare program. The NHPM will also on focus revamping over 150,000 smaller community health centers into government-regulated “health and wellness centers” with the aim of improving access to quality health services in rural communities.

This is an important step towards achieving Universal Health Coverage (UHC) — defined by the World Health Organization as a state in which “all individuals and communities receive essential quality health services they need without suffering financial hardship.” Access to quality and affordable healthcare is imperative for individuals to lead productive and fulfilling lives and for countries to have strong economies. With a growing population expected to hit 1.6 billion by 2050, there is a clear need for investment and reform in India’s health sector.

Prime Minister of India Narendra Modi, who has served since 2014 and is running for reelection next year (Image)

Although India guarantees access to free government health services under its public healthcare system, bottlenecks in accessing the services such as a scarcity of hospitals, poor quality of service, and an insufficient number of beds, forces many families to seek private care and incur high-out of pocket payments. As a result, the private sector currently provides almost 80 percent of outpatient and 60 percent of inpatient care in India. However, with annual per-capita income in India at only $1,900, much of India’s poor are unable to afford quality private treatment for their health needs — steep medical costs drive around 63 million Indians into poverty and rural bankruptcy every year.

While many are praising Prime Minister Narendra Modi’s push to reform India’s public healthcare system via NHPM, critics question whether such an ambitious program is achievable. Economists estimate the program will cost the government billions of dollars to operate, which is much greater than is accounted for under Finance Minister Arun Jaitley’s current allocations. "How they're going to pay for this is puzzling all of us," said Dipa Sinha, professor of economics at Ambedkar University in New Delhi.

There are also concerns over whether the program will undermine the current, already failing public health system to the point of collapse. Moreover, while it may reduce the financial strain associated with illness, some worry that it won’t improve the overall health of the population without the program covering preventative health services. With India’s general elections coming up next year, many critics view the rollout of the initiative as a pre-election effort to woo voters to Modi’s party, the BJP, after the leader’s 2017 demonetization program was widely labeled a failure. Modicare makes a tall promise, but whether the proposal is too good to be true remains up in the air.